334 Efficiency of Mask Ventilation in Preterm Infants at Birth

Abstract

Aim: To investigate the efficiency of mask ventilation in preterm infants after birth. Methods: Recordings of airway pressures and gas flow of infants < 32 weeks gestation needing mask ventilation at birth were reviewed. Respiratory support was delivered with a T-piece and mask. Inflations in the first 5 minutes were analyzed for significant leak (> 60%), low expired tidal volume (VTe) < 3.0 ml/kg, high VTe (> 15 ml/kg in initial sustained inflations of 3 seconds, > 10 ml/kg in subsequent inflations). Airway obstruction could only be observed leak was minimal. Results: Recordings of 26 infants (mean (SD) gestation 28.0 (1.6) weeks, birth weight 1120 (322) grams) were suitable for analysis. In 26 infants 130 sustained inflations (5 (2) per infant) were given and median (IQR) leak was 84 (40-100)% and VTe was 2.1 (0-6.7) ml/kg. In 20/26 infants 1513 subsequent inflations (75 (50) per infant) were given and leak was 56 (8-100)% and VTe 2.9 (0.3-5.8) ml/kg. The proportion of infants and percentage of inflations with significant leak, low VTe, high VTe and obstruction are shown in Table 1. Conclusion: During mask ventilation of preterm infants at birth tidal ventilation is frequently low and hampered by mask leak and obstruction. High VTe occurred occasionally.